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There is a long and enduring argument about whether or not marijuana is a “gateway drug,” i.e., one that leads significant numbers of users to harder drugs such as heroin or cocaine. The stakes are pretty high in getting the answer right: gateway drug rehab for users of marijuana may be able to keep these users from “graduating” to extended (and addicting) use of the more damaging drugs.Correlation vs. causationThe problem in analyzing this question is not in simply showing that significant numbers of users first use marijuana then heroin. The difficulty in making the case lies in whether or not correlation implies causation. In other words, is it a coincidence or does the use of one lead to the use of the other?Recently, a study was conducted to answer that very question: do adolescents who smoke pot increase their odds of landing in drug rehab — for heroin addiction?On first look, the study (from the Karolinska Institute in Sweden), suggests that marijuana could be a gateway drug. And the study seems to indicate that the causation is there: in other words, marijuana changes your brain’s chemistry enough to make the user susceptible to harder drugs. So perhaps there is a case to be made for making gateway drug rehab available to pot smokers.What the study foundThe experiment went like this: twelve rats were split into two equal groups. Each group were aged 4-7 weeks old (the equivalent of rat-adolescence). Six of the rats ingested enough tetrahydrocannabinol (THC), the active ingredient in marijuana, to simulate the equivalence of one joint every three days. The other six rats were left alone.Flash forward: all 12 rats were given catheters by which they could self-administer doses of heroin. Both groups took the heroin and plateaued out their dosages — and at the same time. But the pot-ingesting rats plateaued out at a higher level of heroin consumption than the rats that did not ingest the THC.What this meansIt was the conclusion of the scientists that the THC rats were de-sensitized to the effects of the heroin and so they needed more of it before they reached their plateau. This is the classic definition of a gateway drug’s effects. And, by ingesting more heroin, the rats were at risk of becoming seriously addicted — thereby increasing the necessity of gateway drug rehab.In other words, the study seems to suggest that the THC-rats were at a higher risk of addiction because of the pot they ingested.However, on closer examination, this does not necessarily imply that marijuana use among adolescents leads to heroin addiction. What it does suggest, however, is that changes in brain chemistry may make the teen more susceptible to addiction if they try heroin. In other words, once they begin using heroin, they need more to get high and stay high.And it isn’t just heroin — any opiate would do. If the adolescent or teen was a regular pot smoker and then used, say, OxyContin, his or her tolerance might be raised to a level high enough that the teen might take too much — and become addicted. This, of course, increases the possibility that they would need gateway drug rehab.ConclusionSo does marijuana lead to harder drugs? Probably not. The study does suggest that a person’s tolerance to opiates goes up after regular use of marijuana. The study, however, does not suggest that a marijuana user would naturally crave heroin or OxyContin simply as a consequence of smoking pot. Other factors may be in play: A user’s judgment might become impaired over time and, as a result of peer pressure, the individual may begin using stronger drugs in order to “fit in.” But the study does not find that marijuana leads to heroin.Regardless of how it happens, it is important to understand that gateway drug rehab may be in order in these cases. The user’s family and close friends must be aware of this and stand ready to help the user recover.